It has been bred into us as First Responders/Emergency Response Team members that you do not show emotion or weakness when it comes to a horrific call. You are told from the beginning (at least when I started nearly three decades ago) that you will see some horrible and awful things, “Suck it up as you signed up for this. If it bothers you that much, then maybe this isn’t the job for you.” So, for the majority of my career which accounts for well over 20,000 calls, I buried and locked away the mental trauma because that is what you are supposed to do. I can tell you now how incredibly wrong that advice was.
For most of my career I was able to compartmentalize and bury all the horror I had seen while working the streets. It became “normal” for me to mentally remove myself emotionally (so I thought) when it came to working on another human being that was either dead or died while in my care. I became so accustomed to seeing mangled and burned bodies, homicides, violence, fatal car accidents, that my mind became numb to seeing it. What I didn’t realize was all that cumulative “mental trauma” that I was experiencing unbeknown to me would rear its ugly head and come back to bite me. Although it took 24 years for it to come out of hiding, when it did, it was something I never saw coming until it was too late. I thought I was immune and mentally tough, and that PTSD only happened to the weak minded. Afterall, I was a fireman. I ran into the chaos when everyone else ran out. I was wrong.
Luckily for me, I had an amazing cast of people that supported me through my dark times. From my incredible wife, a small group of close friends that I trusted, and a therapist that specialized in treating first responders. The unfortunate part is that my department only offered free professional help through the city psychologist which nobody trusted. Knowing that he had the power to do the one thing we first responders dread the most, take us off the truck, away from our “station family”, and helping people, I was on my own to find the help I needed. Luckily, I had the mental fortitude to acknowledge that I needed help, so I sought out a therapist that understood first responders and more importantly, one that I trusted. Today I am healthy, happy, and passionate about making sure other first responders get the help they need.
So, how does this relate to you as a manager or your Emergency Response Team? It is your responsibility as a manager to ensure your team members have the available resources to help those in need. We will discuss options and ideas to implement for not just those that respond to emergencies, but for those individuals that witness events as well. With that, let’s get started on what exactly PTSD is.
Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event by either experiencing it or witnessing it. Symptoms may include flashbacks, trouble sleeping, anxiety, nightmares, depression, uncontrollable thoughts about the event, as well as other issues. Symptoms usually appear within a few months of the event, but in some cases, it may take years for them to appear. This can be from a single event or for first responders, it tends to be cumulative events over years and years of seeing or experiencing traumatic events. Each person is unique in how they manage fear and stress, so it can vary as to the time and severity of potential PTSD in which people may experience. In cases where PTSD develops, the usual treatment involves psychotherapy and, in some instances, medication combined with therapy. There are studies that suggest PTSD may be prevented with early intervention.
Let’s start with prevention. A first and easy step that can be implemented after a traumatic incident is talking about it. The key to this type of discussion is to ensure that it is neutral and open. This is not the time to finger point or play the blame game. It should have those that were involved or witnessed the event as well as a neutral third party that can bring constructive and independent perspective. It is even better if that third party has experienced a similar event as they may understand and relate to the emotions that the others are experiencing. This is where having a small peer support group would be beneficial to expediting this process. This initial discussion needs to happen as soon as possible and no later than 24 hours after the initial incident while feelings and details are fresh. This short timeline also aids in the prevention of emotions based off inaccurate or false details. Again, this is the time to talk about what they saw and how they feel without any punitive consequences. It is also imperative that this closed-door discussion remains confidential in order to ensure trust among those that have been affected. If word gets out about personal feelings, then you run the risk of losing trust within the peer group support.
Next, there should be in place a professional alternative option. After the initial peer support group discussion takes place, you may have individuals that need additional help with the emotional process of dealing with whatever they experienced. These individuals may want the additional help immediately, or it could be something that arises weeks to months later. Either way this is where having a professional therapist is crucial to assisting those that need the additional help. If your business or company can not afford such a service, then at a minimum have a list of qualified professionals that an employee can choose in order to receive the emotional and mental help they need.
Lastly, have an open-door policy when it comes to helping every employee. This is not just for management but should encompass everyone within the company. There will always be people in non-management positions that employees are going to feel more comfortable with talking to about emotional issues. Those individuals need to have a process to follow to share with management or human resources. If the only person to go to is management, then you will prevent many from seeking help. That is just the cold hard reality in most cases. When it comes to addressing PTSD or mental health, there must be significate care to ensure it is done right. If management gives serious thought and genuine effort to setting up avenues for help, that will help build confidence and trust within a company which goes a long way.
I want to finish with the hard reality of PTSD. If this continues to be a subject that is ignored and not addressed properly, then lives are lost by those affected with severe PTSD and innocent lives are left to deal with those repercussions. In many cases we see people that don’t know what to do when PTSD begins to affect them, so they self-medicate with alcohol, drugs, self destructive behavior, and in some cases suicide. This all has negative consequences for a company as many of those destructive behaviors affect employee morale, lost work time, increased liability, and in the worst-case scenario results in the death of an employee. As a company, management, or employee, we owe it to our coworkers and staff to address a silent destructive illness that is a reality amongst a profession where people are routinely hurt or killed. As safety professionals this is one area that routinely gets ignored or forgotten. We can do better because one day it very well maybe you that needs help. Don’t think that you are immune from PTSD because you are not. Take it from me, I know firsthand.
